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Komplikationen des refraktiven Linsenaustausches

Complications after refractive lens exchange

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Zusammenfassung

Im vorliegenden Artikel werden spezifische Komplikationen nach refraktivem Linsenaustausch (RLA) vorgestellt. Das gesamte Komplikationsspektrum des RLA entspricht weitgehend dem der Kataraktchirurgie; im Unterschied zur Kataraktchirurgie werden jedoch beim RLA besonders kurze oder besonders lange Augen behandelt und das Durchschnittsalter der Patienten ist deutlich geringer. Es werden vor dem Hintergrund dieser Sondersituation in dem vorliegenden Artikel speziell das Risiko von Netzhautpathologien nach myopem RLA erörtert und beim hyperopen RLA typische, durch das kurze Vordersegment bedingte, operative Schwierigkeiten dargestellt. Moderne Kleinschnittchirurgie mit Verwendung faltbarer Intraokularlinsen und scharfer Kantenstruktur zur Reduzierung einer Nachstarbildung zusammen mit einem optimalen postoperativen Management können einer Minimierung RLA-spezifischer Komplikationen Rechnung tragen. Zusammenfassend ist der RLA zur Korrektur hoher Ametropien in der presbyopen Altersgruppe derzeit trotz einer geringen Komplikationsrate eine sichere und effektive refraktive Therapieoption.

Abstract

This overview discusses specific complications after refractive lens exchange (RLE). The complication spectrum is similar to that following cataract surgery, with some differences: RLE is implemented in very short or very long eyes, and the average patient age is significantly lower. Regarding specific situations, this article particularly considers the risks of retinal pathologies after myopic RLE and reviews the typical intraoperative difficulties induced by a short anterior segment in hyperopic RLE. Modern microincisional surgery and the use of foldable intraocular lenses with a sharp edge design reduce posterior capsule opacification and, together with optimal postoperative management, may reduce RLE-specific complications. In summary, despite the minor complication rate, RLE for the correction of high ametropias in the presbyopic age group is a safe and effective refractive treatment option.

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  1. Universitäts-Augenklinik München, Ludwig-Maximilians-Universität, München, Deutschland

    D. Kook & A. Kampik

  2. Klinik für Augenheilkunde, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    T. Kohnen

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Kook, D., Kampik, A. & Kohnen, T. Komplikationen des refraktiven Linsenaustausches. Ophthalmologe 105, 1005–1012 (2008). https://doi.org/10.1007/s00347-008-1829-5

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